Ronco C, Ricci Z, Bellomo R, Bedogni F
Department of Nephrology, St. Bortolo Hospital, Vicenza, Italy.
Cardiology. 2001;96(3-4):155-68. doi: 10.1159/000047399.
Fluid overload may occur in patients with congestive heart failure. Under normal conditions, this is treated with inotropic support and diuretics. However, when diuretics fail, fluid removal becomes uncontrolled and other therapeutic options must be undertaken. Extracorporeal ultrafiltration is a possible solution to restore a status of fluid balance close to normal. Several new technologies have made ultrafiltration available today in all centers and easy to be instituted. Acute isolated schedules of ultrafiltration may, however, be too aggressive and result in severe hemodynamic instability. For this reason, continuous extracorporeal techniques have been applied in such patients and the therapy is generally carried out with success. Excellent hemodynamic stability, a good cardiovascular response and often diuresis restoration are the most common effects encountered using continuous forms of extracorporeal fluid removal. The potential for a home-based application of these techniques represents a further stimulating concept to be investigated.
充血性心力衰竭患者可能会出现液体过载。在正常情况下，这可以通过使用正性肌力支持药物和利尿剂来治疗。然而，当利尿剂治疗无效时，液体清除就会失控，必须采取其他治疗方案。体外超滤是恢复接近正常液体平衡状态的一种可能解决方案。如今，一些新技术使超滤在所有中心都可实现且易于实施。然而，急性单次超滤方案可能过于激进，会导致严重的血流动力学不稳定。因此，连续体外技术已应用于此类患者，并且该治疗通常取得成功。使用连续形式的体外液体清除最常见的效果是具有出色的血流动力学稳定性、良好的心血管反应以及通常能恢复利尿。这些技术在家用方面的潜力是一个有待研究的更具启发性的概念。
